Sleep Apnea

Definition

Sleep apnea is a disorder resulting in brief periods when breathing stops during sleep. These periods can last for 10-30 seconds at a time, up to 20-30 times per hour. Over the course of the night, interrupted breathing can occur up to 400 times.

There are 3 types of sleep apnea:

Obstructive—temporary, partial, or complete blockage of the airway (most common)

Central—temporary failure to make an effort to breathe

Mixed—a combination of the first 2 types

Causes

Sleep apnea is the result of a combination of factors. Major causes depend on the type of sleep apnea:

Obstructive—During sleep, muscles in the body to relax. Relaxation of the muscles around the throat and neck allow some soft tissue to sink toward the throat. For some people, there is enough soft tissue to block the airway and interrupt normal breathing.

Central—Breathing is controlled by signals from the brain. If the signals are not working properly, breathing can be slowed or interrupted.

Mixed—A combination of both types.

With all types of sleep apnea, the brain senses the breathing interruption and signals the body to wake up. Waking up restores normal breathing but breaks the sleep cycle. Poor sleep can cause daytime fatigue and over time lead to other serious medical conditions like high blood pressure or depression.

Mechanical Therapy

Continuous positive airway pressure
(CPAP)
is a machine that forces a constant and continuous flow of air through a hose connected to a mask. It is used while you sleep. The air flow prevents the soft tissues in the throat and neck from collapsing and blocking the airway.

Oral Appliances

Oral appliances that help keep the tongue or jaw in a more forward position may help those with mild to moderate sleep apnea.
They can also be used for those with severe obstructive sleep apnea who cannot use CPAP therapy or have tried it without success.

Surgery

In some cases, surgery may be advised. It is most often helpful in children.

Types of surgery that may be done to treat severe cases of sleep apnea include:

Tracheotomy
—For life-threatening cases of sleep apnea, an opening is made in the windpipe to allow for normal breathing.

Phrenic nerve stimulation (central sleep apnea)—An implanted device stimulates the phrenic nerve to contract the diaphragm, a sheet of muscle under the lungs. When the diaphragm contracts, air is drawn into the lungs.

Bariatric surgery may help with weight loss in those who do not have success with other methods
. This surgery may reduce many of the complications that are related to obesity, including sleep apnea.

Medications

Only used in central apnea,
acetazolamide
may help improve the ability to regulate breathing.

Supplemental oxygen may be given if blood levels of oxygen fall too low during sleep, even after opening the airway.

Prevention

You may be able to prevent sleep apnea by maintaining a
healthy weight. Avoid alcohol, nicotine, and sedatives, which may contribute to airway obstruction.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.